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Report: Physician time, shared decision-making seen as most effective in boosting patient engagement

A NEJM Catalyst summary of of a NEJM Insights Council report says:

“Many definitions of patient engagement are debated, but when it comes down to what approaches are most effective, members of the NEJM Insights Council — consisting of healthcare executives, clinical leaders, and clinicians — emphasize clinician time with patients. The next most effective approach is shared decision-making, defined as clinicians and patients working together to produce the best outcomes possible. Only these two initiatives have broad support from our survey respondents. At the bottom of the list of effectiveness is remote monitoring using wireless devices/wearables.”

To read the summary of the report, please hit this link.

To read the full report, please hit this link.

Routes to boosting patient engagement

This FierceHealthcare article looks at high-tech and high-touch ways to boost patient engagement in their own care.

Among the observations:

“While an NEJM Catalyst survey reveals that 69% of providers are using patient engagement strategies, the figure should be much higher, says Kevin Volpp, M.D., Ph.D., director of the Center for Health Incentives and Behavioral Economics at the University of Pennsylvania’s Perelman School of Medicine.

“But even as health information technology programs and platforms advance the cause, there are still some low-tech and high-touch ways to engage patients. The best methods, of course, are a blend of the two.

“Some payers and providers rely on tried-and-true approaches, enlisting everyday technologies such as communication tools and paper-based education methods. Others are tapping a slew of emerging technologies, from apps to patient portals.”

To read more, please hit this link.

7 ideas for maximizing ACO potential


This HealthAffairs article looks at  what Accountable Care Organization funders can do to maximize an ACO’S potential. Among the suggestions of the authors, Andrea Ducas, Rob Houston, Tricia McGinnis, and Stephen Shortell:
1. “Encouraging movement toward greater accountability. Experts still grapple with the question of what ACOs are really accountable for. There is a need to clarify goals (for example, cost reduction, quality and value improvement, transfer of risk to providers) and to use these insights to drive accountability…. ”

2. “Breaking down policy and regulatory barriers
. Barriers exist that inhibit optimal ACO data sharing, such as privacy regulations, software interoperability, and regulations limiting how Medicaid funding can be used to address the social determinants of health. Minimizing these barriers may help ACOs and their partners to create more efficient and innovative ways to serve patients.”

3. “Facilitating multipayer alignment. Support for alignment—for example, aligning payment methodologies with quality measurement and reporting requirements, but also aligning efforts across payers and programs—may help ACOs develop more population-based models, reduce measurement confusion, and increase provider participation.”

4. “Refining risk adjustment across populations and services. More accurate risk adjustment methods that include factors like the social determinants of health could make ACOs better able to bear more financial risk and to support population-based models, particularly for people dependent on the safety net.”

5. “Managing market consolidation. Additional research is needed to determine the effects of ACO arrangements on market consolidation. The results from such research could inform future regulatory or other market action that may be taken by state or federal governments, if they felt it was warranted.”

6. “Encouraging greater patient engagement in care. Funding could be used for research or pilot projects to improve patient engagement. More specifically, foundations could explore ways that well-designed incentives might promote shared decision making and greater self-care management.”

7. “Improving measurement of ACO success. Randomized controlled trials and other formal, but more feasible, methods of evaluating ACO interventions and performance relative to non-ACO activity could help to identify key factors in ACO success and lead to adoption of more scalable models.”


Nurses playing bigger role in facility design


Post-surgery resuscitation room.

Nurses are being more intensely consulted in hospital facility design.

Kathy Okland, president of the Nursing Institute for Healthcare Design, says the growing use of evidence-based design and the recognition that design can have an important influence on medical outcomes is making nurses more important in the planning and building of facility interior architecture.

“Nurses are very familiar with evidence-based practices based on their experience in evidence-based medicine,” Ms. Okland told Healthcare Design, “so it’s a natural alignment for them to step into [evidence-based design] and interpret that for others who may have found that science to be rather new.”

Consider how nurses are collaborating in hospital-room design and redesign to reduce patient pain, and hospital-acquired infections, increase patient engagement and raise caregiver efficiency.

Jaynelle Stichler, a Okland colleague, says  that healthcare design is now a nursing-career option. She told Healthcare Design that more firms specializing in healthcare architecture are hiring nurses to “translate the needs of the healthcare environment to the architects and the design language back to the clinical providers.”





Patients aren’t ‘equal partners’


Is it time to give the phrase “patient engagement” a rest?

Betsy Weaver writes in MedCity News that the phrase too often is “used to mean involving a patient as an ‘equal partner’ in his or her care—or, worse, letting the patient take the lead! What does that really mean and who wants that?!”

“As patients, we choose our doctors and nurses because they have something we don’t: expertise, experience and perspective. Sure, we need to take some responsibility in helping our healthcare professionals help us—by following their instructions, taking our meds as directed, getting regular health checkups and striving to live healthier lives. And we need to learn from them what are appropriate expectations—for example, for pain or how to manage our care after discharge. Beyond that, we have jobs of our own … we don’t want or need theirs!”

“What patient engagement should mean is two-way communication engaging patients throughout the care continuum—before anything happens, during an episode of care and after their discharge from the hospital.”


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